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中文摘要: 目的 探讨痔上黏膜环切钉合术( PPH) 联合多普勒引导下痔动脉结扎术（DG-HAL）对预防以出血为主要症状的Ⅱ～IV期内痔的临床疗效、术后并发症的观察,尤其是预防术后出血的效果，探索一种能进一步提高其治疗彻底性、术后并发症少的微创手术方法。方法 采用随机对照的方法，将175例以出血为主要症状的Ⅱ～IV期内痔患者随机分成PPH 联合DG-HAL手术治疗组( 85 例) 和单纯行PPH 手术对照组(90例) 。比较两组患者的手术情况和术后并发症发生情况。结果 两组患者手术时间和住院时间、术后最大疼痛评分差异均无统计学意义( P＞ 0.05) ; 而治疗组术后触动痔动脉搏动数量明显少于对照组(P＜0.05)。治疗组患者术中、术后出血的人数明显少于对照组(P＜0.05)，但两组患者治疗后恶心呕吐、尿潴留、肛门失禁和吻合口狭窄差异均无统计学意义(P＞0.05)。结论 PPH联合多普勒引导下DG-HAL通过术中结扎痔动脉的优势，能有效防止Ⅱ～IV期内痔术中、术后出血，从而减轻患者术后出血风险，值得在临床上推广。
Abstract:OBJECTIVE To observe the therapeutic effect of PPH combined doppler- guided hemorrhoidal artery ligation on the preventing of the intraoperative and postoperative hemorrhage for internal hemorrhoids．METHODS 175 cases of internal hemorrhoids from II to Ⅳ stage were randomly divided into two groups, of which 85 cases were treated by DG-HAL in the therapeutic group and 90 cases were treated by PPH in the control group, and then to compare the postoperative effect and complications between the two groups. RESULTS There were no significant differences in aspects of the surgery duration，hospital stays, and postoperative maximum pain score between the two groups(P>0.05) , but the number of postoperative haemorrhoids artery pulse was significantly smaller in the therapeutic group than the control group. Compared to the postoperative complications with the control group, the number of intraoperative and postoperative hemorrhage was smaller in the therapeutic group ( P<0.05), but the numbers of postoperative nausea or vomiting, uroschesis, anal incontinence and anastomotic stenosis between two groups were not statistically different(P >0.05)．CONCLUSION PPH combined DG-HAL on the preventing of the intraoperative and postoperative hemorrhage for internal hemorrhoids was obviously effective.
文章编号：3201804040 中图分类号：R657.1+8 文献标志码：
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| 作者 | 单位 |
| 龚建安①，吴跃锐①# |
| Author Name | Affiliation |
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